Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2016
Randomized Controlled Trial Comparative StudyEffect of Topical Morphine on Acute and Chronic Postmastectomy Pain: What Is the Optimum Dose?
Poorly controlled postoperative pain is strongly associated with the development of chronic pain. We aimed to investigate the effect of topical morphine (in 1 of 3 doses: 5, 10, or 15 mg) on acute and chronic neuropathic pain after modified radical mastectomy for cancer breast. ⋯ Topical morphine controlled acute postmastectomy pain in a dose-dependent manner and reduced the incidence and severity of chronic postmastectomy pain syndrome.
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Reg Anesth Pain Med · Nov 2016
Comparative StudyLocal Infiltration of Analgesics at Surgical Wound to Reduce Postoperative Pain After Laparotomy in Rats.
There is an increasing use of local infiltration analgesia (LIA) to reduce postoperative pain. Despite widespread use of LIA, wide variations in drug combinations and concomitant use of systemic analgesics have made it difficult to determine the optimal drug combinations for LIA. Using a previously validated rat laparotomy model, the optimal LIA combination of medications to reduce postoperative pain was determined. ⋯ Our animal study suggests that clinical trials with low-dose LIA combinations of local anesthetic, nonsteroidal anti-inflammatory drug, and corticosteroid may be useful for reducing postoperative pain after laparotomy.
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Reg Anesth Pain Med · Nov 2016
Time Since Inciting Event Is Associated With Higher Centralized Pain Symptoms in Patients Diagnosed With Complex Regional Pain Syndrome.
We hypothesized that patients with complex regional pain syndrome (CRPS) with a longer time since their inciting event would demonstrate more symptoms of centralized pain. ⋯ Our findings suggest that the longer the patients have CRPS the more likely they are to report symptoms suggestive of centralized pain. These data may explain why some patients with a longer duration of CRPS do not respond to peripherally directed therapies.
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Reg Anesth Pain Med · Nov 2016
Randomized Controlled Trial Comparative StudyA Randomized Controlled Trial of Ultrasound Versus Nerve Stimulator Guidance for Axillary Brachial Plexus Block.
Ultrasound-guided techniques improve outcomes in regional anesthesia when compared with traditional techniques; however, this assertion has not been studied with novices. The primary objective of this study was to compare sensory and motor block after axillary brachial plexus block when performed by novice trainees allocated to an ultrasound- or nerve-stimulator-guided group. A secondary objective was to compare the rates of skill acquisition between the 2 groups. ⋯ We were unable to demonstrate a difference in the efficacy of axillary brachial plexus block performed by novices when ultrasound guidance was compared with a nerve stimulator technique. There was evidence of similarly improved clinical performance of novices in both groups.